Lipid emulsion inhibits the cardiac toxicity caused by chloroquine via inhibition of reactive oxygen species production / 대한마취과학회지

Background@#Lipid emulsion (LE) is effective in treating intractable cardiac depression induced by the toxicity of highly lipid-soluble drugs including local anesthetics. However, the effect of LE on chloroquine (CQ)-evoked cardiac toxicity remains unclear. This study aimed to examine the effect of Lipofundin MCT/LCT, an LE, on the cardiotoxicity caused by CQ in H9c2 rat cardiomyoblasts and elucidate the underlying cellular mechanism. @*Methods@#The effects of CQ (1 × 10-4 M), LE, and the reactive oxygen species (ROS) scavengers mitotempo and N-acetyl-L-cysteine (NAC), alone or combined, on cell viability and migration, apoptosis, ROS production, calcium levels, mitochondrial membrane potential, and adenosine triphosphate (ATP) were examined. Additionally, the effects of LE on the activities of catalase (CAT), malondialdehyde (MDA), and superoxide dismutase (SOD) induced by CQ were assessed. @*Results@#Pretreatment with LE, mitotempo, or NAC reversed the reduction in cell migration and viability, mitochondrial membrane potential, and ATP levels evoked by CQ, and inhibited the increase in cleaved caspase-3, ROS, and calcium concentration induced by CQ. LE inhibited the increase in Bax expression, terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells, MDA activity, and late apoptosis, and reversed the reduction in SOD and CAT activity induced by CQ. CQ did not significantly affect cleaved caspase-8 expression, and LE did not significantly affect CQ concentration. @*Conclusions@#Collectively, these results suggest that LE (Lipofundin MCT/LCT) inhibits the cardiotoxicity and late apoptosis induced by CQ toxicity via the intrinsic mitochondrial apoptotic pathway that is associated with direct inhibition of ROS production.

A Predictive Factor in Overactive Bladder Symptoms Improvement after Combined Anterior Vaginal Wall Prolapse Repair: A Pilot Study

PURPOSE: We aimed to determine whether a preoperative urodynamic parameter is a valuable predictor for the persistence of OAB symptoms after the AVP repair. MATERIALS AND METHODS: 65 OAB patients with concomitant POP-Q stage III, IV anterior vaginal wall prolapse underwent a surgical repair were involved. All the patients were subjected to a preoperative urodynamic study, for whom the OABSS on questionnaire were preoperatively recorded. We firstly analyzed the correlation between the BOOI and the OABSS, then randomly divided patients into two groups: the group A (high PdetQmax, BOOI> or =20) and the group B (low PdetQmax, BOOI<20). In each group, the OABSS was repeatedly measured post-operatively and the change were analyzed. RESULTS: 31 patients were classified as the group A and 34 patients were classified as the group B. The group B showed significant decrease of symptom score in daytime frequency (p<0.01), urgency (p=0.04), urge incontinence (p=0.03), nocturnal frequency (p=0.01) and total score (p=0.01). The group A showed no significant decrease of symptom score in daytime frequency (p=0.42), urgency (p=0.61), urge incontinence (p=0.3), total score (p=0.15) except nocturnal frequency (p=0.01). CONCLUSIONS: A preoperative pressure-flow study can be a valuable tool in predicting the OAB symptoms change after the combined AVP repair. While the AVP repair leads to the improvement of OAB symptoms generally, some patients with a higher preoperative PdetQmax are still in need of the additional medical treatment.

The Significance of Persistent Abnormal Urine Cytology

PURPOSE: We investigated the factors that predicted later transitional cell carcinoma (TCC) in a subgroup of patients with abnormal cytology and negative initial evaluations. MATERIALS AND METHODS: From January 2002 to June 2007, we retrospectively identified 58 patients. Cases were considered discordant if a work-up of urine cytology was abnormal although initial cystoscopy, upper tract evaluation, and biopsies resulted in a negative or benign diagnosis. Patients who could complete a urine cytology test after 6 to 8 weeks and who were followed up for at least 1 year were included in this study. According to later TCC demonstration, we compared risk factors for TCC between the later TCC group and the benign group and evaluated the independent factors that predicted later TCC by use of a Cox proportional hazards regression model. RESULTS: Of the 58 patients, the mean follow-up was 12.7+/-17.3 months (range: 2-83 months), and 14 patients (23.7%) had a prior history of TCC. During follow-up, 9 patients (15.3%) had TCC and 1 patient had prostate cancer. In the later TCC group, the incidence of a prior history of TCC (p=0.03) and persistent abnormal cytology (p<0.001) were higher than in the benign group in univariate analysis. In the Cox proportional hazards regression model, persistent abnormal cytology (p=0.033, relative risk (RR): 17.380 [95% CI: 1.265-238.783]) was the only independent factor to predict later TCC. The mean follow-up duration of later TCC demonstration was 8.55 months (range: 2-32 months). CONCLUSIONS: Our results suggest that in the setting of persistent abnormal urine cytology with a negative initial evaluation, 53.3% of patients will later develop TCC. Patients with persistent abnormal cytology need intensive follow-up within 1 year.

Affinity of Endothelial Cells to a Polyurethane Vascular Graft: A Preliminary Animal Study

PURPOSE: Autologous vessels remain the gold standard for vascular grafts in microanastomoses. However, they are sometimes unavailable and have a limited long-term patency. Synthetic vessels have high success rates in large-diameter reconstructions but failed when used as small-diameter grafts due to graft occlusion. It has been proven that endothelial cell seeding improves prosthesis performance and long-term patency. Among polyurethane, PET and ePTFE, polyurethane has the best affinity to endothelial cells and mechanical properties closest to human vessels. We examined the ability of endothelial cells to attach to a polyurethane graft manufactured by the electrospinning method. METHODS: Endothelial cells, which were cultured from porcine internal jugular veins, were attached to polyurethane grafts with an internal diameter of 3mm. The same cells were attached to allogeneic decellularized porcine internal carotid artery grafts as controls. Both of the 10mm-long grafts were exposed to endothelial cells in a well for 1 hour. Each well contained 2x10(5) endothelial cells. The graft materials were rotated through 90 degrees every 15 minutes in order to minimize the effect of gravity. The extent of cell attachment was examined with the MTT assay. RESULTS: The MTT assay showed good incorporation of endothelial cells into both grafts. For the evaluation of affinity, the number of attached cells was counted at 10 fields of microscopic examination with x40 magnification. Endothelial cells adhered more to polyurethane grafts (mean, 127.4+/-6.2 cells) compared to porcine artery grafts (mean 45.8+/-5.1 cells)(p<0.05,Mann-Whitney test). CONCLUSION: In this study, we attached porcine endothelial cells to polyurethane grafts, manufactured by electrospinning. The grafts exhibited a better affinity to endothelial cells than allogeneic decellularized porcine internal carotid artery grafts. It is suggested that the time required for endothelial cells to attach to decellulized artery grafts may be longer than that which is required for attachment to polyurethane rafts.

Complications in the Recipient Sites of Autologous Rib Cartilage Grafts for Microtia

PURPOSE: Microtia is a congenital anomaly resulting from abnormal development of the branchial apparatus. Although significant modification and improvement of operative procedures for the reconstruction of the auricle with a natural appearance have been reported, postoperative complications, such as infection, flap necrosis and deformity, still remain serious problems in patients. Many studies with long-term results have focused mainly on operative procedures for an acceptable auricular shape without consideration of possible complications. METHODS: We conducted a retrospective study on postoperative complications at the recipient sites of 183 patients who underwent auricular reconstruction with autologous rib cartilage grafts from November 1987 to January 2007 at the Division of Pediatric Plastic Surgery, Seoul National University Children's Hospital. Patients were analyzed in terms of the kinds and incidences of complications, and their treatment options. RESULTS: Postoperative complications included wound dehiscence, flap necrosis, infection, hypertrophic scar, auricular deformity and absorption of rib cartilage grafts. The complications occurred in 47 patients with a complication rate of 25.7%. Fourteen patients were successfully managed with conservative treatment. However, surgical treatment was required in 51 reoperations(33 patients) of total 329 operations. CONCLUSION: Postoperative complications at the recipient sites of autologous rib cartilage grafts occurred with relatively high incidences and required long-term treatments and multiple surgeries. The results of this study may provide information on the causes and proper management of postoperative complications as well as safe procedures for the reconstruction of the auricle.

Trends in the Emergence of Ciprofloxacin-resistant Escherichia coli and the Relationship with Underlying Diseases in Patients with Urinary Tract Infection / 대한비뇨기과학회지

PURPOSE: The increased use of antibiotics may be the main factor responsible for the development and spread of bacterial resistance. This study demonstrated the relation between quinolone use and the rate of isolating ciprofloxacin-resistant(CIPRO-R) Escherichia coli(E.coli) in patients with urinary tract infection(UTI). MATERIALS AND METHODS: From 2001 to 2006, we determined antimicrobial use for 2,803 in terms of the defined daily dose(DDD) and the antimicrobial use density(AUD), and we surveyed the isolation rates of CIPRO-R E.coli in UTIs in both inpatients and outpatients. We also analyzed the correlation between the number of prescriptions and the resistance rates. RESULTS: Of the 637(22.7%) CIPRO-R E.coli isolates, 297(46.6%) were from inpatients and 340(53.4%) were from outpatients. There was a statistically significant correlation between the rate of isolating CIPRO-R E.coli and the amount of quinolone use for the inpatients(r=0.815, p<0.05) as well as the outpatients(r=0.804, p<0.05). A logistic regression analysis identified previous quinolone use as the independent risk factor(odd ratio: 2.604 [95% confidence interval(CI): 1.639-4.137]) for CIPRO-R E.coli in inpatients. Also, these CIPRO-R E.coli showed low sensitivity to ampicillin and trimethoprim/sufamethoxazole(TMP/SMX) in the inpatients(10.4%, 27.3%) and outpatients(5.1%, 27.1%), respectively. CONCLUSIONS: Our study shows a significant correlation between ciprofloxacin resistance and quinolone use, and previous quinolone use seems to be the risk factor for CIPRO-R E.coli bacteriuria. It is necessary to keep antimictrobial therapy under constant surveillance for the prevention of CIPRO-R E.coli.

The Effect of Tamsulosin and Nifedipine on Expulsion of Ureteral Stones after Extracorporeal Shock Wave Lithotripsy / 대한비뇨기과학회지

PURPOSE: We evaluated the effect of tamsulosin and nifedipine on expulsion of ureteral stones after extracorporeal shock wave lithotripsy(ESWL). MATERIALS AND METHODS: We evaluated 96 upper or lower ureteral stone patients. All patients received a single session of ESWL with a piezolith- 3000 and received twice-a-day oral treatment of 5mg trospium chloride. The patients were randomly divided into three groups. Group 1 received once a day oral therapy of 0.2mg tamsulosin. Group 2 received once a day oral therapy of 30mg nifedipine. Group 3 was used as the control group. All patients took oral medication for 2 weeks, and then we analyzed the stone expulsion rate, side effects, and mean numbers of emergency room(ER) visits for pain control. RESULTS: There were no differences in the 3 groups in stone size, location, age, and sex. The total stone expulsion rate was significantly higher in group 1(84.4%) compared with group 3(60.6%)(p=0.032). Patients with lower ureteral stones in group 1 showed a higher expulsion rate(94.1%) than those of group 3(66.7%)(p=0.042). There was no difference in stone expulsion rates between group 2(67.7%) and group 3(60.6%). CONCLUSIONS: These result suggest that adjunctive medical therapy with tamsulosin after an ESWL increased the stone expulsion rate of ureteral stones, especially lower ureteral stones.

C-reactive Protein is a Useful Marker to Predict the Severity and Early Response of Acute Pyelonephritis in Women / 대한비뇨기과학회지

PURPOSE: To evaluate the values of C-reactive proteins(CRP) for predicting the severity and results of treatment for acute pyelonephritis in women, we compared the severity of symptoms and signs, the laboratory findings and the initial serum CRP according to the early response to treatment. MATERIALS AND METHODS: We retrospectively analyzed 298 female patients who were diagnosed with acute uncomplicated pyelonephritis between January 2002 and Match 2007. All the medical records were reviewed for a variety of factors, and the baseline characteristics and CRP level were compared between the patients with an early response to treatment and those without according to the 3rd hospital day urine analysis. RESULTS: The initial white blood cell(WBC) counts, the CRP level, the neutrophil ratio and severity of symptoms were significantly higher in the delayed response groups than those in the early response groups. The age, history of previous pyelonephritis, symptom duration, body mass index(BMI), and the number of positive blood and urine cultures were not different between the two groups. According to the results of the multivariate logistic regression analysis, the CRP level, neutrophil ratio and mild symptoms were independent predictive variables that affected the delayed response. The odds ratios(95% CI) were 1.078(1.028-1.131) for the CRP, 1.030(1.001-1.060) for the neutrophil ratio and 9.268(1.072-80.166) for the severe symptoms. The differences between the areas under the ROC curves for CRP and the WBC counts and for the CRP level and neutrophil ratio were statistically significant(p<0.001 and p<0.05, respectively). CONCLUSIONS: We found that the discriminatory power of the initial CRP level was high with regard to predicting an early response. So, we were able to determine a CRP level that would be useful in guiding hospitalization.

Artery to Collecting System Communication after Abdominal Trauma

Degenerative vascular disease, previous arterial surgery, long-term ureteral stenting, pelvis surgery, and radiotheraphy are reported as causes of artery-to-collecting-system communication.. Artery-to-collecting-system- communication associated with blunt trauma is rare, but potentially fatal. The diagnosis is very difficult and requires a high degree of suspicion. We were able to make the diagnosis based on the characteristic finding of contrast-enhanced computed tomography (CT) obtained in the early phase, equivalent to the finding obtained in the corticomedullary phase of the kidney. We report a case of artery to collecting system communication due to blunt abdominal trauma following a fall, which was treated by embolization.

Artery to Collecting System Communication after Abdominal Trauma

Degenerative vascular disease, previous arterial surgery, long-term ureteral stenting, pelvis surgery, and radiotheraphy are reported as causes of artery-to-collecting-system communication.. Artery-to-collecting-system- communication associated with blunt trauma is rare, but potentially fatal. The diagnosis is very difficult and requires a high degree of suspicion. We were able to make the diagnosis based on the characteristic finding of contrast-enhanced computed tomography (CT) obtained in the early phase, equivalent to the finding obtained in the corticomedullary phase of the kidney. We report a case of artery to collecting system communication due to blunt abdominal trauma following a fall, which was treated by embolization.

Comparison of the Lithogenic Risk Factors for First Time and Recurrent Stone-formers / 대한비뇨기과학회지

PURPOSE: The lithogenic risk factors were compared between the first time stone patients and recurrent stone patients according to age and gender. MATERIALS AND METHODS: We performed stone metabolic studies on first time stone formers (67 men and 42 women) and the recurrent stone formers (40 men and 20 women). We analyzed the groups' excretion differences for the lithogenic and inhibitory constituents such as calcium, uric acid, oxalate, sodium and citrate; we measured volume from the 24-hour urine samples and calcium, uric acid, sodium, potassium, chloride and phosphate from the serum samples. Hypercalciuria, hyperoxaluria, hypocitraturia and a low 24-hour urine volume (<1,500ml) were compared between the two groups according to age and gender. RESULTS: Hypocitraturia was the most common metabolic abnormality in all the groups. The incidence of hypocitraturia was higher in the recurrent stone formers (50.0%) than in the first time stone formers (48.6%), but this was not statistically significant. A low urine volume was shown to have more significant association (p<0.05) for recurrent stone formers (33.3%) compared to the first time stone formers (18.3%). CONCLUSIONS: Hypocitraturia was the most common lithogenic risk factor for stone patients. In the recurrent stone formers, a low urine volume is the risk factor that differentiates them from the first time stone formers.

Comparison of Shock Wave Lithotripsy (SWL) and Rigid Ureteroscopic Stone Removal (URS) for Treatment of Upper Ureteral Stones / 대한비뇨기과학회지

PURPOSE: The aim of this study is to compare the shock wave lithotripsy (SWL) with the rigid ureteroscopic stone removal (URS) in order to establish the efficacy in treating upper ureteral stones according to the stone size. MATERIALS AND METHODS: We reviewed 328 patients who have been treated for upper ureteral stones between January 1999 and December 2002. 227 patients were treated with SWL, and 101 patients were treated with URS. We analyzed the success rates of the stone removal, reasons for failure, and complication rates of each procedure. RESULTS: The overall success rate of the URS was 93.1%. In terms of stone size, the success rates were 94.5% (10mm), respectively. With the SWL treatments, the overall success rates after the first, second, and third sessions were 59%, 78%, and 92.5%, respectively. According to the stone size, the success rates were 96.5% (10mm) after third sessions, respectively. The success rate was significantly affected by the size of the stone in the SWL group, but this was not the case with the URS group. The associated complication rates of URS and SWL were 11% and 7%, respectively. CONCLUSIONS: In this study, URS was relatively more efficacious than SWL when the stone was larger than 10 mm. The proper selection of patients for in situ SWL or URS would improve the results of the initial treatment.

A Testicular Tumor Incidentally Found after Trauma / 대한비뇨기과학회지

A testis tumor is comparatively rare and most of them are discovered as a palpable asymptomatic mass. We recently experienced two cases of incidental testicular tumor during scrotal exploration for trauma. Pathologic study revealed a mixed germ cell tumor and mature teratoma, so we report here on these two cases with a review of the related literatures.

A Testicular Tumor Incidentally Found after Trauma / 대한비뇨기과학회지

A testis tumor is comparatively rare and most of them are discovered as a palpable asymptomatic mass. We recently experienced two cases of incidental testicular tumor during scrotal exploration for trauma. Pathologic study revealed a mixed germ cell tumor and mature teratoma, so we report here on these two cases with a review of the related literatures.

Effect of Selective Cyclooxygenase-2 Inhibitor on Apoptosis of the Human Prostate Cancer Cell Xenografted in Nude Mice / 대한비뇨기과학회지

PURPOSE: Cyclooxygenase (COX)-2, an inducible enzyme that catalyzes the formation of prostaglandins from arachidonic acid, is overexpressed in various cancers, including prostate cancer, and cell lines. COX-2 has been reported to play an important role in carcinogenesis. The aim of this study was to evaluate the effects of a selective COX-2 inhibitor (meloxicam) on the cell proliferation, apoptosis, Bcl-2, and Bcl-xL expression in prostate cancer. MATERIALS AND METHODS: 20 male nude mice were subcutaneously inoculated with 1 million PC-3 cells expressing COX-2. After 1 week, the mice were divided into two groups of 10 mice. Group 1 was left untreated, which served as a control. Group 2 was treated with meloxicam (40mg/kg) four times a week for 3 weeks. After the 4 weeks experimental period, the tumors were immunohistochemically assayed for apoptosis (TUNEL) and proliferation (Ki-67). The COX-2, Bcl-2 and Bcl-xL mRNA expression levels in the tumors were evaluated by RT-PCR. RESULTS: The meloxicam had no effect on the tumor cell proliferation, but induced inhibition of PC-3 tumor cell growth and apoptosis. The Bcl-2 expression decreased in the meloxicam-treated group, but there was no significant difference between the two groups. The Bcl-xL expression was significantly down regulated in the meloxicam-treated group (p<0.01). CONCLUSIONS: Our results suggest that a selective COX-2 inhibitor suppresses PC-3 cell tumor growth in vivo. Tumor growth suppression was achieved by the induction of tumor cell apoptosis, and was associated with a decreased Bcl-xL expression, which is one of the Bcl-2 related genes.

Effects of Oral Administration of Citrate, Thiazide, Allopurinol and Magnesium on Renal Calcium Oxalate Crystal Formation and Osteopontin Expression in a Rat Urolithiasis Model / 대한비뇨기과학회지

PURPOSE: It has previously been reported that citrate, thiazide, allopurinol and magnesium (CTAM) have inhibitory effects on calcium oxalate crystallization, but the effects of CTAM on the matrix proteins of stones in vivo has not been studied. Using an ethylene glycol-induced urolithiasis model, we investigated the effects of CTAM on renal crystallization and the expression of osteopontin (OPN), which is an important stone matrix protein. MATERIALS AND METHODS: Adult Sprague-Dawley rats (200-250gm) were divided randomly into 6 groups of 10 rats. Group 1 was left untreated, and served as a control. Group 2 (CID group) was fed 0.8% ethylene glycol and 1% ammonium chloride (crystal-inducing diet, CID) in drinking water for 4 weeks. Groups 3, 4, 5 and 6 (CTAM groups) were fed the same CID as group 2, but were also treated with either potassium citrate or hydrochlorothiazide or allopurinol or magnesium hydroxide, for 4 weeks, respectively. We biochemically analyzed the 24-hour urine and serum samples. The renal calcium content was measured by atomic absorption. The kidneys were histologically examined for crystal deposit with HandE staining, and for OPN expression with immunohistochemical staining. RESULTS: The grade of calcium oxalate crystal deposits, and renal calcium content, were significantly decreased in the CTAM groups compared to the CID group, which also correlated with the decreased expression of OPN proteins in the kidneys of the CTAM-treated rats. CTAM were all effective in preventing calcium oxalate crystal formation, and decreasing the expression of OPN in rat kidneys. CONCLUSIONS: Our results suggest that CTAM are effective in preventing calcium oxalate stone formation, and that OPN plays an important role in calcium oxalate nephrolithiasis.

Effects of Uninephrectomy on Calcium Oxalate Nephrolithiasis in Ethylene Glycol-Treated Rats / 대한비뇨기과학회지

PURPOSE: A renal compensatory hyperfunction after the surgical removal of a contralateral normal kidney includes hyperfiltration and hyperexcretion. These changes in the remaining kidney may increase or decrease the stone-forming potential. The effects of a uninephrectomy (uNX) on stone formation were investigated in an animal model. MATERIALS AND METHODS: Adult male Sprague-Dawley rats (300-350gm) were divided into 3 groups (n=10 in each). Group 1 were left untreated and served as the control. Group 2 were fed 0.8% ethylene glycol and 1% ammonium chloride (crystal-inducing diet, CID) in their drinking water for 4 weeks without a uNX. Group 3 were fed the same CID for 4 weeks from 2 weeks after the uNX. The stone metabolic study analyzed the excretion rate differences of the lithogenic and inhibitory constituents in the serum and 24-hour urine in the rats. The crystal deposits were examined by polarizing microscopy and the renal calcium content was measured by atomic absorption spectroscopy. RESULTS: There was a significant difference between the control group (56.44+/-4.90 ng/gm) and the CID-treated groups in terms of the renal calcium content (p< 0.01). In addition, the magnitude of the increase was significantly higher in group 3 (2875.50+/-1783.90 ng/gm) than in group 2 (1053.54+/-866.71ng/gm) (p< 0.05). The mean grade of the crystal deposit in group 3 (3.60 +/- 0.70) was markedly higher than in group 2 (2.40 +/- 1.35) (p< 0.05). When comparing group 2 and 3, the serum creatinine level increased significantly (p< 0.05), whereas the creatinine clearance and 24-hour urinary excretion of citrate decreased significantly (p< 0.05). CONCLUSIONS: The results suggest that uNX increases the stone-forming potential of the remaining kidney in the presence of other lithogenic risk factors.

Effects of Uninephrectomy on Calcium Oxalate Nephrolithiasis in Ethylene Glycol-Treated Rats / 대한비뇨기과학회지

PURPOSE: A renal compensatory hyperfunction after the surgical removal of a contralateral normal kidney includes hyperfiltration and hyperexcretion. These changes in the remaining kidney may increase or decrease the stone-forming potential. The effects of a uninephrectomy (uNX) on stone formation were investigated in an animal model. MATERIALS AND METHODS: Adult male Sprague-Dawley rats (300-350gm) were divided into 3 groups (n=10 in each). Group 1 were left untreated and served as the control. Group 2 were fed 0.8% ethylene glycol and 1% ammonium chloride (crystal-inducing diet, CID) in their drinking water for 4 weeks without a uNX. Group 3 were fed the same CID for 4 weeks from 2 weeks after the uNX. The stone metabolic study analyzed the excretion rate differences of the lithogenic and inhibitory constituents in the serum and 24-hour urine in the rats. The crystal deposits were examined by polarizing microscopy and the renal calcium content was measured by atomic absorption spectroscopy. RESULTS: There was a significant difference between the control group (56.44+/-4.90 ng/gm) and the CID-treated groups in terms of the renal calcium content (p< 0.01). In addition, the magnitude of the increase was significantly higher in group 3 (2875.50+/-1783.90 ng/gm) than in group 2 (1053.54+/-866.71ng/gm) (p< 0.05). The mean grade of the crystal deposit in group 3 (3.60 +/- 0.70) was markedly higher than in group 2 (2.40 +/- 1.35) (p< 0.05). When comparing group 2 and 3, the serum creatinine level increased significantly (p< 0.05), whereas the creatinine clearance and 24-hour urinary excretion of citrate decreased significantly (p< 0.05). CONCLUSIONS: The results suggest that uNX increases the stone-forming potential of the remaining kidney in the presence of other lithogenic risk factors.

Two Cases of Female Sexual Dysfunction Treated by Estrogen and Testosterone / 대한남성과학회지

Female sexual dysfunction is now of great concern and have a relatively high prevalence. It is related with psychosocial disorder, organic disease and iatrogenic cause. But until recently, basic science and clinical study on it is limited and medical therapy stays in early experimental steps except conventional hormone replacement therapy. Hormonal based female sexual dysfunction can be caused by dysfunction of the hypothalamic-pituitary axis, surgical or medical castration, menopause and premature ovarian failure. We report two cases of female sexual dysfunction derived from hormonal deficiency. One case is about premature menopause induced and the other is about rare form of adult onset idiopathic hypogonadotropic hypogonadism.